title: Adding pregabalin or gabapentin for the management of community-treated patients with painful diabetic peripheral neuropathy: a comparative cost analysis.
abstract: OBJECTIVE
  Painful diabetic peripheral neuropathy (pDPN) is a highly prevalent complication of diabetes mellitus, which is associated with substantial costs to society and national health systems. This economic impact varies depending on the therapeutic management provided to patients. The objective of this study was to compare healthcare resource utilization and costs among pDPN patients newly treated with pregabalin or gabapentin in routine medical practice.
  
  
  METHODS
  We performed a retrospective medical records study of pDPN patients newly treated with pregabalin or gabapentin as an add-on therapy who are covered by the Badalona Serveis Assistencials (BSA) health plan, a healthcare provider in Spain, from 2006 to 2009. Healthcare resource utilization and days off work were assessed. The societal perspective was used to estimate costs.
  
  
  RESULTS
  Three hundred and ninety-five records were eligible for analysis: 227 (57.5%) included pregabalin and 168 (42.5%) gabapentin. Mean (standard deviation) concomitant use of analgesics throughout the study was higher in the gabapentin cohort [3.9 (2.2) vs. 3.1 (2.1); p < 0.05], mainly due to greater use of non-narcotics (78.0 vs. 71.8%; p < 0.05) and opioids (32.7 vs. 28.6%; p < 0.05). Healthcare costs accounted for 59.2% of total costs, of which 71.9% occurred in primary care, with a mean cost per patient of €2,476 (year 2010 values). Adjusted mean (95% CI) total costs were significantly lower in pregabalin-treated patients [€2,003 (1,427-2,579)] than in gabapentin-treated patients [€3,127 (2,463-3,790)] (p = 0.013), mainly due to lower healthcare costs [€1,312 (1,192-1,432) vs. €1,675 (1,537-1,814); p < 0.001].
  
  
  CONCLUSIONS
  Adding pregabalin to existing pDPN therapy resulted in lower total healthcare costs and lower resource utilization than resulted from adding gabapentin.
authors.affiliation: Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis Assistencials SA, Gaietà Soler, 6-8 entlo, 08911, Badalona, Barcelona, Spain, asicras@bsa.cat.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sicras
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
authors.forename: Ruth
authors.initials: R
authors.lastname: Navarro
authors.forename: Albert
authors.initials: A
authors.lastname: Planas
mesh_terms: D000328:Adult; D000368:Aged; D000588:Amines / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D016527:Drug Costs; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D000069583:Pregabalin; D012189:Retrospective Studies; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin